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Summary
Pages 1-10

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From page 1...
... to form a committee that would develop a framework for building a national chronic disease surveillance system. This system would focus primarily on cardiovascular and chronic lung disease and be able to provide data for analysis of race, ethnic, socioeconomic, and geographic region disparities in incidence and prevalence, functional health outcomes, measured risk factors, and clinical care delivery.
From page 2...
... However, the committee resolved to devise a framework and infrastructure that could, to the extent possible, be applicable to other chronic diseases. The committee also recognized the rich history and accomplishments of existing surveillance resources, which can be leveraged in designing a national surveillance framework that would be timely, reliable, and comprehensive for current users of surveillance information.
From page 3...
... Claims data may also include geographic identifiers for persons or service providers and may be used to map geographic patterns of the incidence of hospitalizations, other services provided, and healthcare costs, which can be used in analyses of healthcare disparities. Although administrative claims data are useful at the macro level to describe patterns of use and mortality, limitations do exist, including coding errors, limited clinical information, and diagnostic misclassification such as underdiagnosis, overdiagnosis, and misdiagnosis common with cardiovascular and chronic lung diseases.
From page 4...
... These may be provided by health insurers, integrated delivery systems, commercial providers of health information tools and support, and freestanding personal health records. Timely access to personally relevant information has been a driving force for patients to form, join, and share experiences and data within a range of organizations independent from historically defined public health, healthcare delivery, and health research entities.
From page 5...
... e HIE stands for health information exchange. examples of different users of surveillance information that can be found at the micro, meso, and macro levels of surveillance.
From page 6...
... Successful implementation of a framework for nationwide surveillance of cardiovascular and chronic lung diseases requires a mechanism to coordinate, monitor, and support the multiple data collection systems that contribute to the surveillance system. Furthermore, the system must provide ways to ensure that the elements collected by the system can evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease.
From page 7...
... This general framework, while evolved specifically for chronic heart and lung diseases, is anticipated to be broadly applicable to other chronic health conditions, including the increasingly common co-occurrence of multiple chronic health conditions in the same individual. Recommendation 3 The committee recommends that HHS adopt the framework illustrated in Figure S-1 as a guide for national surveillance of cardiovascular and chronic lung diseases.
From page 8...
... Enhancing the use of current data sources requires coordination of data collection efforts, harmonization of some elements, expansion to include patient outcomes, and community-tailored items. Coordination of data collection efforts across federal, state, and local systems and healthcare delivery organizations requires, to the extent possible, standard definitions of key risk factors and outcomes, interventions, and a mechanism to link subjects and providers across the different data sources.
From page 9...
... Furthermore, the system will be most beneficial if comparisons can be made between and among various communities; this requires collection of comparable data. Recommendation 8 The committee recommends that HHS develop a cardiovascular and chronic pulmonary disease survey question bank and technical support for use by tribal, state, and local agencies; nongovernmental organiza tions; and individual researchers for the purpose of enhancing the quality and comparability of population health surveys in order to identify trends in risk factors, diseases, treatments, and outcomes.
From page 10...
... Many existing sources of surveillance information provide high-quality data that are critical to understanding the trajectory of cardiovascular and chronic lung diseases. However, those data lack standardization and cannot be linked across sources, and many of them are not readily accessible.


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